Why Is Saving Babies’ Lives Not Enough?

In 1978, Tennessee was the first state to pass a law requiring infants to be placed in an infant restraint system while driving in a car. I don’t know if it caused an uproar or not, but as the years have passed, we’ve grown to realize exactly how important that decision was. Within a few years, all other states had followed their lead[1] and nationwide we now see a 70% reduction in infant deaths from traffic accidents[2]. Given that children are regularly in cars these days, the reduction is even more remarkable. Although I was unable to find exact numbers for nation-wide statistics, certain state statistics were available. In Tennessee, over a six-year period from 1978 to 1983, 81 children under the age of 4 died in traffic-related accidents and 79 of them were not wearing restraints[3]. In Washington State between 1970 and 1979, prior to the implementation of a law requiring the use of infant car seats, 148 children aged 0 to 4 were killed, 146 of them were unrestrained[4]. A rough extrapolation to all 50 states might suggest that over a 10-year period, there were approximately 7,400 children under the age of 4 who died most of whom need not have. That’s 1850 infants under the age of 1 (for the sake of an argument, assuming they’re equally distributed). No wonder everyone today is on board with infant safety and laws requiring everyone to use infant restraint systems. In fact, if anyone so much as suggested that we get rid of these laws, there would be riots in the streets, right?

But here’s the thing about this article, it actually isn’t about car seat safety at all. It’s about breastfeeding.

Almost a year ago, Gisele Bundchen made a comment that there should be a worldwide law requiring mothers to breastfeed for the first six months of their baby’s life and took an amazing amount of heat for it[5]. She was criticized by many for suggesting such an outlandish thing – after all, isn’t the way we feed our babies our choice? And while a law wouldn’t work for those who simply cannot breastfeed (though many laws have loopholes for situations where it simply is impossible to follow), I think she’s not horribly wrong in her comments, but I’m not supposed to admit that.

Hear me out: Sometimes laws have to change before we see the societal changes needed to make things happen. Should breastfeeding be mandatory or legalized? No. But it’s ideas like this that sometimes force people to look at what’s broken in a system and try to fix it, which is why they are worth discussing. If it’s so important that we talk about legalization, well, what measures need to be in place to make that happen? Then we get to ask: Why not just put those measures in place for families to take advantage of? Or why not make some changes that would allow people to think realistically about the societal effect of the push for formula, like prescription formula or making breastmilk banks more widely available or even more publicity for milk sharing or even just abiding by the WHO code to restrict the marketing of formula.

Last year, the Obama administration signed into law the Affordable Care Act which included provisions for mothers to pump at work in an effort to get more infants breastmilk, a good start if we want to see change for families looking to breastfeed. In the UK, some hospitals are now ending the practice of providing mothers with free formula in order to try and increase breastfeeding rates[6]. Compared to other countries, the US and UK lag rather far behind on the breastfeeding scale. For example, the percentage of women who ever breastfeed in Norway is 99%, in Brazil is 97%, in Mexico is 92%, and in Canada is 90%[7]. Why does this matter? Outside of the benefits for general health and intelligence discussed elsewhere (see here), it has strong implications financially and even stronger mortality implications for infants. A recent analysis of the cost of the lack of breastfeeding in the USA found that if 80% of mothers exclusively breastfed for the first six months, as per the World Health Organization’s recommendations and what Ms. Bundchen took so much heat for suggesting, the US would save $10.5 billion dollars per year and 741 lives, nearly all of which would be infant (< 1 year) lives[8].

I’m going to repeat that: $10.5 billion dollars and 741 lives. If you can get the number to 90%, it becomes $13 billion dollars and 911 lives.

How is this? Well, those are the numbers based on the diseases we know formula increases the risk for. Even in our modern, Western, medicalized world. These are numbers based on US families doing US things with US health care. Because as much as people like to say that there aren’t really effects of using formula, at a population level there are. (Remember that the population and individual level are very different things.) And as such, even with all our advancements, the proliferation of formula use is killing babies.

If you compare these numbers to those of infants who died because of a lack of restraint in car seats, it’s four times the number of lives saved in that age group – approximately 1850 infants under the age of 1 in car seats, and 7400 infants, most under the age of 1, for breastfeeding. And yet, as a society and even on an individual basis, this doesn’t seem to concern us. If you ask the same person whether babies should be able to sit in a car unrestrained and whether society needs to do more to increase the number of women who breastfeed for six months, you’ll probably get equally emphatic no’s to both questions, yet the lives saved are greater in the second case. Now, one might argue that the numbers for car deaths would increase as we use cars more than we did when the first analyses were done in the 1970s and 80s and I’ll happily agree to that. But those deaths would have to quadruple to hit the level of deaths that are occurring because of a failure to breastfeed which isn’t the case – in fact, the US Department of Transportation has claimed that, “In 2008, an estimated 244 lives were saved by the use of child restraints”[22], far less than the number that would be saved by exclusive breastfeeding.

I have to ask: how did we get here?

For years, women simply breastfed. And those who could not breastfeed for whatever reason had others in their community who would feed their child or, as society became more complex and industrial, they employed a wet nurse. However, as wet nurses fell out of style, people started replacing breastmilk with animal milk, and this trend continued to rise after the invention of the rubber nipple in 1845[9]. But even in the early 20th century, breastfeeding remained the primary way to feed babies with other supplementation only occurring when necessary[10]. However, changes were taking place that would soon lead to the drastic decline of breastfeeding in Western societies we’re now trying to fix.

One of the most notable changes was the growth of pediatrics as a medical specialty. While pediatrics first emerged in the mid-19th century with Arthur Jacobi being considered the first pediatric doctor[11], it took a while for this field to expand and take root in most communities. The American Academy of Pediatrics wasn’t formed until 1930, and it has since exploded with membership increasing from 35 in 1930 to more than 60,000 today[12]. While the development of the pediatrics was great for the general health of children (as doctors learned to treat children as children and not adults), it seems that the effects on breastfeeding were less than desirable, despite the fact that the initial work that led to formula came from a need to have an alternate supply of breastmilk for babies that didn’t require moms (freezing storage of breastmilk was still not developed)[13]. While wet-nurses had been the go-to for the vast majority of civilization, they posed problems for pediatricians. As wonderfully put by Kara Swanson, “[Wet nurses] represented the all-female world of practical expertise that the pediatricians were attempting to supplant with their scientific knowledge in order to establish themselves as a profession”[14]. Arguably then, the biggest side effect of this emergence of pediatrics was the scientific focus suddenly put on breastfeeding. This was highlighted in 1922 by the development of a machine to powder human milk by two undergraduate students at MIT[15]. While this device itself posed no problems to breastfeeding, and in fact was developed to help preserve breastmilk for babies, it seems to have triggered the idea that milk should become a technology. That science can do better than moms in what it creates. The idea was that if you break it down enough, you can figure out what’s going on and then improve upon it. And for a while there, doctors actually believed that science had done just that. By the early 1970s, less than a quarter of women were breastfeeding at birth[16], with doctors and hospitals pushing the use of infant formula on new mothers (a practice which still continues today in some places) because of their belief that it was superior to mother’s own milk. We now know this not to be the case, but the damage was done.

But it’s unfair to place the majority of the blame on doctors because they were simply responding to the needs of a time. It is possible that eventually they would have become interested in breastfeeding and science would have taken its course and developed formula, but I’d be negligent to place the blame squarely on the shoulders of doctors and scientists. They were simply responding to a larger problem that really can be seen as the foundation of the problem for breastfeeding – the industrialization of society. You see, in the early twentieth century, standard medical advice was to breastfeed – all doctors were promoting it because they saw the deleterious effects on infants who were not breastfed. However, more and more women were weaning their children early and being forced to put their infants on a non-breastmilk diet because of one major problem – employment[17][18]. Women had to work for wages and without community support, a wet nurse, or pumping, they had little choice but to find an alternative to breastmilk. This had been an ongoing problem for some years and thus doctors were left with little choice but to begin the hunt for an alternative. As with most aspects of parenting, the Industrial Revolution truly altered the way in which we approached child-rearing, starting with the most basic problem of how to feed a child when mom can’t be there. Unfortunately, it perhaps would have been possible to fight the government at the time to push for better laws to help families, but there’s one more factor that needs to be explored: Women.

As far back as the Industrial Revolution, even middle- and upper-class women were opting for alternative means to feed their infants, against the advice of midwives and doctors at the time[19]. And this was not because they had to work, but simply out of a desire to return to activities they had previously been doing, putting forth the notion that breastfeeding is simply a burden. By pushing so hard for an alternative, they let business avoid any moral or legal obligation to do what is best for a family and they let science take over the role of feeding their children. It’s difficult to disentangle the role of women, doctors, and business during the mid-twentieth century as they all had strong interests in keeping babies formula-fed, but when we return to the debate today, it is very squarely centered on a woman’s right to choose how to feed her child and somehow this has led to fights against systems to help breastfeeding.

Today, the issue of employment rears its ugly head yet again. Politicians and businesses continue to fight against laws that would force them to enact other family- and baby-friendly measures like extended maternity leaves or bringing baby to work allowances, all of which benefit mom and baby by more than just increasing breastfeeding. I imagine they all believe it would be less “efficient”, if we want to go ahead and talk in euphemisms (which politicians always do), and they’d probably be so dramatic as to argue that the entire economy would suffer. (Bullsh!t. Other countries with extended leaves do just fine, thank you very much.) However, there were battles when states started implementing car seat laws. In Tennessee, the law was enacted in 1978 and yet in 1983 only 30% of babies were restrained while driving[20]. Across the US, despite massive educational campaigns, only half of children were restrained in 1984[21]. But because of the importance of saving children’s lives and avoiding serious injury, those in charge continued to persist in not only passing laws requiring parents to purchase and install car seats, but in enforcing the law and educating parents about why this was so important.

We seem to have finally begun the educational campaign in favour of breastfeeding with some levels of success. After all the damage we did in the mid-twentieth century, we’re just beginning to recover. But it’s a long road, with no legal standing to help the infants who would benefit most from breastmilk, and as such it becomes a much harder sell than the car seat, despite the greater benefits. In short, there are plenty of barriers to increasing breastfeeding rates and plenty of work to be done to improve them. But by looking back as to how we got to this stage, hopefully we can see the folly in some of the excuses going forward and finally give all families the support they need to breastfeed or to obtain breastmilk for their babies.

28 Comments

This is a well-thought out and researched article. And as a breastfeeding advocate, previous tandem nurser, and extended breastfeeder for 6 years, I applaud your efforts to increase breastfeeding initiation. And as someone who had a wonderful breastfeeding experience, I’d like to shout from the rooftops: Breastfeeding is Awesome! You should ALL breastfeed!

But I can’t support mandating breastfeeding. Yes, it is indesputably healthier for babies to be breastfed than formula fed. However, until you can separate lactating mother from the milk she produces, without interfering with said mother, it’s just different than other mandatable safety issues.

A car seat isn’t attached to a mother’s phyiscal body. A safety seat isn’t also a sexual organ which can become stimulated in ways you may rather it not due to body issues or previous experiences. You don’t need to carry your carseat with you to work, along with an apparatus to pump it, another apparatus to support it, another to make sure it doesn’t leak through your good clothes. You don’t need to worry about showing your car seat to strangers accidentally. You don’t need to miss work time and try to find a safe, clean, private place several times per day to pump your safety seat.

And on & on.

I recognize the benefits of breastfeeding. I share them loudly with everyone I can. I tell my wonderful experiences, I offer support. I support increased use of breastmilk banking, greater access of banked milk to women in need, the normalization of wet nursing, milk sharing, breastfeeding in public, and bringing babies to work, and providing working women safe, comfortable places in which to pump.

But I cannot support a law requiring women to feed their babies from their own breasts – no matter how basic and natural and even necessary that seems. Forcing a woman to use her body in a way that doesn’t make her comfortable crosses far too many lines.

I hear all your points. In fact, I’m not sure mandating breastfeeding is the answer, but it’s an option I’m not against. Personally I think formula should be by prescription only and that we work to increase milk banks for women who have problems with breastfeeding.

What I find interesting is that I think many of the problems you cite – pumping at work, the stigma around public breastfeeding – are all things that would change if breastfeeding were mandated. That is, society would have to change the way in which they approach parenting if women have to breastfeed. Longer maternity leaves and a greater acceptance of public breastfeeding (hopefully via the desexualization of the act in others’ eyes) would follow suit because they would have to. These are things that I don’t believe will change without certain legal changes to how we feed babies. But again, whether it’s mandating it or simply making formula a prescription based item or some other option, I think they would all have the same effect.

My questions then are: How do you balance the rights of the mom versus the lives of the babies? And how do you think we get to a place in society where all the great things you mention supporting (e.g., wet nurses, bring baby to work) come to fruition?

“Rights of the mom verses life of the baby”? You’re joking right? In today’s secular society the *wants* of the mom superscede the *life* of the baby for the 1st 9 months of it’s life. The notion that a newborn might be a ‘burden’ on the poor mom who just wants to go back to work and have her “nice clothes” and business paycheck and peers who are too terrified of a sexual harassment lawsuit to dare look at the clevage and leg she’s showing in her oh so appealing ‘don’t you dare call me a mommy’ outfit is anathama to today’s ‘womyn’. Don’t you know that to be equal to a man womyn need: birth control pills, surgery to kill their baby if their birth control fails, nannies/day care centers, artifical milk, and laws detailing how they have to be treated differently than men in the workplace…after all, womyn must be *equal*!

Sorry, vent over.

The post-industrial society may have some perks, but being family friendly isn’t one of them. Women are biologically suited to being the homemaker, and our children need us. Society tells us it’s ok to put outside interests ahead of our families, especially our kids, after all, giving up your ‘lives’ to nurish, care for, and raise our kids is such a primative idea! But women know it’s not, which is why they get so upset when you point out the benefits to all that ‘primative’ parenting type stuff. I don’t agree with mandating breastfeeding, mostly because I have a strong streak of libertarian in me, but I do think formula should only be availible via prescription. If a mother doesn’t want to use her own breasts, let her hire a wet nurse or buy milk. There is absolutely no reason for the average baby to be on formula.

Probably, as we seem more or less on the same page with regards to the whole ‘children need their mothers’ concept. At my college there was the ridiculous “womyns” group (it was the first time i’d seen someone butcher ‘women’ like that and at first I thought someone had mispelled ‘wormyns’, a creature used in the fantasy genera, I had to read the flyer twice before I realized it was a feminist group not some gamer-fantasy group) and I had this nearly overwelming urge to crash one of their meetings: just walk in carrying a sign that said ‘barefoot and pregnant in the kitchen and proud of it’ and walk back out. My (male) friends talked me out of it, although they didn’t have to talk very hard, I know the 1 thing feminists hate more than men are traditional women! I still want to crash a feminist group meeting (NOW perhaps), only now i’d have the toddler in a back carry and the baby in a front sling nursing in addition to the sign.

1. Secularism has nothing to do it with. This is not a religious issue.
2. The rights of the mother outweigh the rights of the fetus during pregnancy because the mother is an autonomous, self sustaining human being and the fetus is a potential, completely dependent, and unable to sustain it’s own life human being. There is no reason to drag choice into this argument.
3. The tone of your post makes it very clear that you are hostile toward working women. Do you think this open hostility is going to help your cause?
4. Please join us in the real world. Women who go back to work when their infants are weeks old, for the most part, do so because they need to pay their rent, buy groceries, and keep their water and electricity connected. It must be nice up there in your ivory tower la la land where there is no poverty, no under employment, no domestic abuse, no men who run off on their children and refuse to pay child support.

1) who said anything about religion or secularism? Neither of my post so much as mentions either in passing.
2) the infant is also a completely dependant, unable to sustain it’s own life human being, just like it was a few months ago. I was, correctly, pointing out that you can’t expect people to put aside their ‘life’ for the ‘best’ of their offspring when they fell they have a right to put their ‘want’ ahead of the very life of their offspring. It’s intrinsecly related
3) it was a ‘rant’, and posted as such. Does it ‘help’ for people to know I don’t agree with working moms? That would assume I have an agenda beyond conversing with a friend. Mom’s shouldn’t be working. They should be home with their kids. And while there certainly are *single* moms who have absolutely no choice but to work, nearly every mom/dad couple make a *choice*, a choice I disagree with, to have mom work. It’s just a blatant lie that a family “needs” two incomes. If there is even a single single income family in the city then clearly a family *can subsist on a single income. Therefore workings moms are choosing a specific lifestyle over that of staying home and taking care of their kids. *you* might think the tradeoff is a good one, I disagree. A bigger house, a better car, new clothes, whatever, to me I don’t think it’s worth moms not being in the home. I have many working mother friends who disagree with me. I think it’s their choice, it’s a legal choice that hardly amounts to abuse so I respect, even if I disagree with, their choice, and will defend their continued right to make that choice.
4)I do live in the real world, the real world were my family of four, soon to be five, is supported by my husband’s lower-end job. Where nearly all of the married working moms I know freely admit they work not so they don’t end up homeless but because they want the higher level of economic life a second job provides them. Where statistically speaking most (married) working moms live well above the poverty line and where things like 2 cars, cable, and internet have become ‘necessities’ and were many working moms could easily work out of the house but choose to leave the house instead.

Working outside the house, like choosing to formula feed, doesn’t make you a ‘bad’ mother. But it certainly makes the situation less than ideal for the child. And common sense, history, and plenty of studies back me up. I won’t apologize or feel bad for being non-pc and having the gall to say an unpopular truth. Moms *should* be married, moms *should* be at home being the primary care giver of their children and moms *should* breastfeed. Not doing any of these things doesn’t make you a bad mother, and I’ll stand shoulder to shoulder for your right to choose those parenting choices. But I also will have the honesty and integrity to tell you to your face it’s less than the best choice in my evidence-backed opinion.

infant formula should be availible by perscription only PERIOD! If oxycotin was availible to the public over the counter we would have a society of strung out junkies, right? Not that formula and oxycotin are the same (though they both pose serious public health hazards). Any parent should know that parenting is NOT convient so picking a feeding option that is convient is just ludacris (and the fact that its not as convienet because you have to get up to make the bottle and buy the formula). We should also be looking into birth practices because since mediclized birth has become the norm so has bottle feeding infants, common procedures at hospitals often disruot mother baby bonding and nursing within the first hour of newborn life. Epidural anstheia and birth interventions such as vacum extraction and ceserean sections result in drowsy babies making it harder for them to stay up and get a latch on mothers breast. Point is we all need to do our part proper childbirth education and breastfeeding education during pregnancy. Most woman go into birth not knowing wether there going to breastfeed or not so they cannot make the proper choices in birth (if applies to individual situation) to revent interventions that can leed to failing breastfeeding relationship. Homebirth for low risk woman who can afford it and are open or professional labor support (Doulas) for woman planning in hospital births who want little or no intervention and successful breastfeeding.

Great article.
I’m living in Holland at the moment, where I saw a midwife during pregnancy (great experience!) being asked on several occasion by widwives of other health care professionals “and how do you plan to feed your child?”….huh? I was so confused. I know now that they were being diplomatic in not ASSUMING that I would breastfeed.
That is when the reality of it hit me: There are actually people who choose not to breastfeed.
I think we would do better to not give women the impression that feeding their baby is an option between two equal or nearly equal choices.

I agreed with you sonja in not allowing women to believe they are making a choice between 2 equal options. The simplest way to cut down formula use among those who most need to nurse is to stop allowing WIC to provide formula unless as suggested it is by rx only. WIC purchases the bulk of formula used in the US. I am nursing baby number 3. In the past always nursed past a year of age and plan to do so with Lily also. My family qualifies for WIC and I can not tell you how much less WIC spends on my family since they only provide supplementa l foods for me as opposed to formula. Also we need much better lactation support. Moms need to know nursing pain isn’t normal.

Great point about lactation support! Sadly women believe that they need to “work through the pain” or other misguided thoughts. Breastfeeding shouldn’t hurt. And if it is, you need to have someone who can help you figure out what’s going on and how to fix it.

I also like the financial point – if government only thought of money (which at times they do), they should be able to see how much could be saved by pushing breastfeeding and reducing the number of babies on formula!

put simply if a plague hit all of those who produce market and make formula and no one else could ever make formula again. our babies would survive and some would be better off for it. breast milk banks would pop up everywhere people would milk share and even nurse each others babies. the only unfortunate side to that story would be all the truly lactose intolerant babies. Even then I’m sure something could be done for them. if the other were to happen I believe rates of SIDs would go up as well as babies getting more sick and possibly dying from that too

Kayla, you’re spot on. There’s a known link between formula-feeding and an increase in SIDS and given the results from the Pediatrics article, we’d see a HUGE increase in deaths and health care costs if women stopped breastfeeding. Other recommendations have been to actually have the US (and Canada) abide by the WHO code which would help immensely in reducing the jump to formula, but when politics are run by corporations, that just won’t happen.

I agree that formula should be by prescription only. That goes along with what I was thinking: taking formula out of grocery stores. It is not food. Also, I think that a good doctor, if asked by a mother for a prescription for formula, will tell the parents to drink a glass of it themselves. Formula stinks adn makes gross diapers. If YOU are unwilling to drink it, then your baby shouldn’t either. I think that any legislation that hurts individual liberty is a bad thing. But the prescription idea is a good choice. Also, I think what would really change the tides is having all nurses, OBGYNs, midwives, nurse-midwives, and any type of professional involved in pregnancy, birth, or pediatrics be trained to be lactation consultants, male or female. This should be a standard medical school class and certification, especially for those going into pediatrics. I think more legislation should be forced on medical personell, not women. We have enough to think about without that.

Lindsay – I really like the idea of removing formula from grocery stores! You’re right that it’s not food. And I absolutely love the statement that more legislation should be forced on medical personel over women. Very valid point 🙂

[…] to be superior to breastmilk by doctors for quite some time (for a full summary of this, see Why Is Saving Babies’ Lives Not Enough?). These two factors alone had a huge impact on reducing breastfeeding rates in Western […]

This post and many of the comments make me so very sad. First there is the wildnleaps from corellation to causation. Then there is the moralistic tone and lack of compassion. But more than anything else, it is the idea that motherhood ~ cause let’s face it, men just don’t count here ~ can be reduced to a biological imperative and the virtuois mother is the one with the lowest risk assessment. I don’t choose to live that way and as a doula, I don’t treat clients ~ women with real needs and messy lives ~ this way. I love breastfeeding ~ I want to see rates increased and will fight like the devil to ensure that all women can exercise the right to feed their babies how and when they want without fear of economic or social reprisals. But mandatory laws? Perscriptions? The case against formula is overstated and the support for breastfeeding needs to increase, but lets do it through compassion, understanding and joy, not through coercion.

Katie,
No doubt support for breastfeeding needs to increase, but I do think there’s room for legislation to help increase breastfeeding rates, just not towards mothers. As I said, I don’t actually believe we should legislate mandatory breastfeeding, but abiding by the WHO code for marketing would be one way to ensure formula use declined. Also laws against passing out samples in hospitals. I question your statement that the case against formula is overstated – many of these articles control for the very variables that people used to try and argue were the real cause of differences (e.g., ethnicity, SES). Do you have evidence it’s overstated? Also, if you read the actual article on cost analysis, it’s not about correlation and the only diseases they included were the ones with the strongest relationships to breastfeeding. In fact, their numbers are quite probably an UNDERestimate.

Yes, there are studies – I was reading a couple this morning – but for every meta analysis or new randomized study that draws one conclusion, there is another that refutes it or another that says that the results are not conclusive or further research is required or later researchers question the methodology or so on and so on and so on. We know breastfeeding is awesome. We know that we need to keep formula companies honest and that some of their practices need to be curtailed (like free samples in hospitals). But the Big Brother “You Are A Terrible Mother Because You Do/DO Not XYZ” is what saddens me, whether it is the decision to homebirth, or co-sleep or not work outside the home or whatever else a mother chooses. It especially saddens me with regard breastfeeding because so many formula feeders are ex-breastfeeders who would desperately love to breastfeed but find – for whatever reason – that they can’t. Sometimes it feels like your best friends have kicked you out of the clique because you don’t dress as well as they do or you got braces or something. Does that make sense? I am not an apologist for formula companies. I have used their products because I felt that in my circumstances I had to. I am grateful they were there and readily available in my supermarket because if I had to get an Rx my child would have gone hungry for a very long time (I’m in the UK and getting a Drs appt can sometimes take a while). I have also exclusively breastfed a child into toddlerhood and loved every second of it. But I recognize that women’s lives are complex and no matter how much education and support you give, when it comes to rearing kids, it simply is not one size fits all. My message is this: let’s educate and advocate and remove as many barriers as we can but let’s not over state the case: breastfeeding and breastmilk have many benefits, both nutritional and emotional. But they are not a magic charm that can prevent a lifetime of disease nor do they make your child a super baby. Formula is a safe, nutritious alternative. Parenting is hard work and takes years of effort and dedication. We all have to make difficult choices – deciding whether to breastfeed, how long to breastfeed and whether to combination feed is just one of those many decisions. Later on you have to decide other things – is it ok to have McDonalds every now and then? When do you let your child watch a PG rated movie? When do you tell your daughter about predatory boys on the playground? Do you help your children access birth control? What do you tell them about alcohol? What if they bring home a friend you don’t like? What do you do when they don’t want to hang out with you anymore? What if they don’t want to go to college but want to join a rock band? It’s hard, sometimes heart breaking work! So let’s keep stuff in perspective, keep up the research so that we can make informed choices (but be honest about their limitations – if the benefit is statistically minimal, just say so!), and then, just *support* each other. But let’s not use guilt inducing messages based on debatable research to change anyone’s behaviour. It doesn’t work in the long term. It just divides. Women have come to far for that.

I love the idea of increasing the availability of breastmilk via banks. I am not a big fan of the thought of mandating something as personal as how you feed your child. As a PND sufferer I can say that assuming all mom’s that don’t breastfeed past a certain point are selfish overlooks the profound mental and emotional investment that goes with being the sole source of nourishment for your child. Trying to shame someone into doing ‘the right thing’ creates negative feelings about something that we should be creating positive associations with. I think a social changes/programmes (such as wider acceptance of baby wearing, bed-sharing, public breastfeeding and better support for depressed and overwhelmed mom’s) will help treat the causes rather than the symptom. On a slightly unrelated note I think that young women who go want through breast augmentation need to be better informed on what this might mean for their future children.

My problem with much of the discourse around breastfeeding is that the experiences of women like myself who are educated (i.e. we read the studies, listened to the advice and lectures of doctors and nurses and “lactavists” and “concerned” family members, etc.) and who *choose* not to breastfeed not because we can’t but because it simply isn’t the right choice for us (not because we’re ashamed of it, or because of our work, or because of society, man!) and our lives are erased. I didn’t want to breastfeed, so I didn’t. My child is happy, healthy, brilliant, and bonded, but she was also a formula/bottle baby–and I hate that I feel the need to say that, because I shouldn’t have to justify myself and my choice not to breastfeed to anyone (but that’s the environment lactavists have created–a culture of shame around formula). I know you aren’t necessarily an advocate of mandating breastfeeding, but to even entertain that as a possibility is horrific! Not all women who are able to breastfeed want to, and it isn’t because we aren’t educated enough to “know” that “breast is best.” Breast isn’t always best.

The discourse around breastfeeding is much like the discourse around abortion. Breastfeeding advocates are, for the most part, progressive women, just like pro-choice advocates. The pro-choice movement has, over the last twenty years, taken on this troubling language that suggests abortions are always a difficult choice, something women only ever do because they have no other option. While that is the case for many women, it’s easy for many others. Some women have abortions because they just want to, because it’s the right choice for them at that particular moment in time–and the pro-choice movement often erases that experience in order to make abortion more palatable to those who feel each abortion needs to be justified on a case-by-case basis.

The reason for this departure is that the women who promote breastfeeding are, likewise, embarking on a noble quest–I think it’s fantastic to promote breastfeeding, and to ensure that women who choose to breastfeed are able to do so as needed, no matter where they are. However, it isn’t progressive in the least to suggest that women who choose not to breastfeed (women who are making an educated decision based on the fact that they know themselves and their lives better than any other person in the world–better than lactation specialists and lactavists and Gisele Bundchen) be forced to do so. Women are people, entitled to a full range of options about what’s best for themselves and their children. Thinking anything less than that is, truly, simply misogynistic.

“Women are people, entitled to a full range of options about what’s best for themselves and their children.”

Two thoughts:

1) Are women given a full range of options? The whole point of my post is NO! I think many women would choose a breastmilk option over formula if given the choice. But alternatives to formula are hard to find unless you’re actively looking.

2) Is formula best for children? Look back at that health cost number – are we doing a disservice to our children, and in turn their mothers, to *assume* formula is “fine”?

How does even entertaining the idea of forcing breastfeeding expand those options? Again, I know you aren’t necessarily advocating for that–but you do say that you’re not against it. HOW does that help women who are consciously choosing not to breastfeed because that IS the right choice for them? (Formula was the best choice for me and my child. I’m not saying it’s the best choice for everyone, but I know myself, my husband, and my child better than anyone–and breastfeeding wasn’t going to work for us. This is a polite way of saying that your remark was condescending.)

The idea of forcing breastfeeding makes people wonder WHY we’d consider such a measure – what’s the point? And when we decide, as a society, we don’t want to force that option, it allows to think outside the current norm to what can we do to make breastmilk more readily available.

As to the idea that “formula” is right for a family – I’m sure there are cases, but more often the real choice is about not breastfeeding, not removing breastmilk from the equation.

I know this is an old post but one I will definitely be sharing. Making formula prescription-only or outlawed except in extreme cases would make mothers really think about the dangers of not breastfeeding. Most people can list benefits of breastfeeding but I don’t think the average person could list the risks carried by formula, because it’s simply not talked about that way, due in large part to political correctness. (To go back to your smoking comparison, it’s perfectly OK to chastise someone for smoking, which affects primarily only their own health, but to criticize someone for choosing formula is super taboo, despite the fact that it directly affects a helpless child.)

People worry that demonizing formula will make those who actually CAN’T breastfeed look/feel bad. I believe the opposite would likely be true. If only those who truly CAN NOT breastfeed used formula, the stigma would be removed. Put bluntly, it is the mothers who CHOOSE formula (those who truly have the choice to do either, yet still don’t breastfeed) who make all FF moms look bad.

It’s misleading to say “breast is best” when breatsmilk is the biological norm. It is what is DESIGNED for the delicate AND matured human digestive system…..there is so much more I would say but(if anyone is still reading current comments here) ……Breastfeeding WAS the hardest thing I ever undertook but after 3 nurslings, 4 years total, tremendous pain, milk protein allergies in all 3 girls, no support from drs to revise lip and tongue ties in all 3…..overall a tremendous amount of pain that could’ve been resolved with attention given to their lts&tts……I wouldn’t trade any of it for the world……ALL my girls ate every 2 hours for over the first year of our time nursing….. it isn’t always easy….it isn’t about what’s easiest or best for US anymore once we bring another human into the world…..
more IBCLCs are needed….not having one in my peds office EVER was infuriating when that was what was keeping my babies alive…my dr never could help me with that…..only give me outdated advice for other things……to which I grinned and nodded…..
I’ve learned more in my private fb group for supporting breastfeeding mothers and mothers to be, in a few years, than I in the peds office in almost 12 years as a parent….none about breastfeeding